Orthopedic brace



Oct. 10, 1933. e. v. ARTHUR ORTHOPEDIC BRACE Filed March 25, 1931 4Sheets-Sheet l Frinna:

0ct.l0, 1933. G. v. ARTHUR 1,930,188

ORTHOPEDI C BRACE Filed March 23, 1931 4 Sheets-Sheet 2 1951 4Sheets-Sheet 3 Filed March 23 (Ittorneg Oct. 10, 1933. 5. v. ARTHUR1,930,188

ORTHOPEDIC BRACE Filed March 23, 1931 4 Sheets-Sheet 4 3nncntor GttorncgPatented Oct. 10, 1933 UNITED STATES PATENT OFFICE 4 Claims.

This invention relates to orthopedic appliances and particularly such asare in the nature of a detachable remedial brace, having for its objectto provide a construction more efficient in operation and less costly tomanufacture than those heretofore proposed.

With these and other objects in View the invention resides in the noveldetails of construction and combinations of parts as will appear morefully hereinafter and be particularly pointed out in the claims.

Referring to the accompanying drawings forming a part of thisspecification and in which like parts are designated by like numerals,-

Fig. 1 is a perspective view of the main brace structure as it wouldappear when applied to a foot;

Fig. 2 is a perspective View somewhat similar to Fig. l and illustratinga reinforcing member which may be used in combination with the mainstructure shown in Fig. 1 or may be used independently thereof;

Fig. 3 is a side elevation of a foot showing in vertical cross sectionthe combined main and reinforcing members in their applied position onthe foot;

Fig. 4 is a development in plan view of the main brace member;

Fig. 5 is a View similar to Fig. 4 of the reinforcing member;

Figs. 6, '7 and 8 are viewsof modifications of the invention presentlyto be disclosed, indicating the application of such modifications to afoot;

Fig. 9 is a side elevation of a foot to which has been applied a mainbrace member similar to that shown in Fig. l but 'having incorporatedtherewith a reinforcement slightly different from that shown in Fig. 2;and

Fig. 10 is a bottom plan view of the parts shown in Fig. 9 in partlyapplied position on the foot.

This invention is particularly directed to a structure for use inconnection with the treatment of fallen arch conditions of a foot, andtherefore to a structure which has remedial effect upon not only themain arch of the foot but the transverse arch as well. This invention isnot especially intended to cover a brace structure which is to be worncontinuously on the foot although it may be so used, but this device isintended for application to a foot either after the muscles thereof havebeen subjected to considerable strain, or to be applied to a foot priorto a contemplated and known subjection of the foot muscles to increasedand severe strains. The device is so planned and constructedthat, afterformation to a foot, it is readily attachable and detachable or may beapplied to a shoe structure and, as illustrated in Fig. 8, the inventioncontemplates the provision of a brace which may be retained either inremedial position or which can be loosened while still being worn, allin accord- T ance with the conditions to which the foot muscles have ormay be subjected and according to the comforts of the patient.

Referring particularly to Figs. 1 and 4 the main brace structurecomprises a cone generally indicated by the numeral 1 which is adaptedto fit over and closely confine the forward instep of the foot. Thiscone has extensions constituting a pair of heel straps 2 and 3, theforward ends of which adjacently merge with the under portion of thecone substantially centrally of the foot; but the straps divergerearwardly so that they pass to the side of and across the back of theheel as clearly indicated in the drawings,

the rear portion of each heel strap preferably being preformed withthree diverging tabs clear- 13 indicated in Fig. 4. That is to say, thestrap 2 has the tabs 4, 5 and 6, and the strap 3 has the tabs 7, 8 and9. The purpose of this construction is to provide a blank which may bereadily fashioned on and adapted to various shapes and conditions offeet, whereby it always results that each heel strap will have at leasttwo tabs for securing the brace on the foot, one of these tabsencircling the ankle to meet the corresponding tab of the other heelstrap, and the other tab passing completely around the rear of the heeland joined to said other heel strap.

Fig. I particularly shows the ultimate utilization of these tabs fromwhich figure it will be seen that the tabs 6 and 9 have been removed asby cutting along the dashed lines 10 and 11 respectively whereby thereremain the tabs'4 and 5 on the heel strap 2 and the tabs '7 and 8 on theheel strap 3. bent around the heel of the patient in order to-get thecorrect size, the extreme ends of said tabs subsequently being securedto the main portion of the adjacent heel strap as by stitching indicatedat '12. their extreme ends fashioned suitably to secure said tabs intight application around the ankle of the foot, there being illustrateda buckle 13 for this purpose. If the foot, to which this brace The tabs5 and 8 have been .100 The other tabs 4 and 7 have was to be applied,had been of different size and/or shape, the tabs 4 and 7 would havebeen cut oil as along the dotted lines 14 and 15 respectively in whichevent the fastener such as the buckle 13 would have been applied to theends of the tabs 5 and 8, and the tabs 6 and 9 would have been securedto the adjacent heel straps 3 and 2 respectively.

In order to maintain proper distribution of applied pressures in thebrace, as well as to prevent too divergent spreading of the heel straps2 and 3, one of said straps has integrally associated therewith (asthrough the stitching 16) one end of a cross strap 17 the other end ofwhich is subsequently secured as by the stitchfin ing 18 to the adjacentheel strap 3 after the brace structure has been applied to the foot, andthe correct length of the cross strap 1'7 ascertained, it beingunderstood that the cross strap is positioned at substantially thecenter of the main arch of the foot. To further assist in the fitting ofthis brace to a foot there is attached to the heel strap 2 a relativelynarrow strap or lacing 19 adapted to be of a length to tie with asimilar lacing secured to the other heel strap 3, the pair of lacingsextending laterally away from their heel straps up and around the instepof the foot as clearly indicated in the drawings.

The cone 1 is preferably formed integrally with the heel straps 2 and 3whereby all of the parts of the main brace with the exception of thecross strap 17 and the lacings 19 and 20 may be stamped as a unitarypiece from a sheet of heavy fabric, leather, or other suitable material.To this end the cone 1, in the precut blank, will have a shape as shownin Fig. 4. That is to say, there will be a portion at the forward end ofthe heel straps 2 and 3, which portion extends laterally of the brace asa whole in a direction at right angles to the generally longitudinalaxis of the brace when applied to the foot. This portion 25 will fit theunderside of the foot in the transverse plane thereof containing theforward or transverse arch. One side of this portion 25 is extended, toform the portion 26, in a direction substantially rectangular to theheel strap 2, said portion adapted to be folded upwardly and over toultimately lie on the top of the foot above the portion 25. The otherside of the main portion 25 is extended in a forwardly and decidedlycurved direction to form the portion 27 which, when brought up and overthe foot will lie in a superposed position with respect to the mainportion 25, the extreme end of the portion 26 being laid exteriorly onthe portion 27 and secured thereto as by the stitching 28 after theportions 26 and 27 have been drawn around the patients foot to obtain aclose fitting thereover. In other words, the blank is formed as shown inFig. 4 so that when the portions 26 and 27 are brought upwardly andacross the top of the patients foot, said portions will naturally fallinto overlapping position and create what' is termed the cone 1.

In the treatment of some foot conditions, it has been found highlyadvantageous to incorporate, with the main brace structure justdescribed, a supplemental member or reinforcing brace which is appliedexteriorly of the main brace, or applied after the main brace has beenput in position on the foot. Such a reinforcing member is shownparticularly in Figs. 2 and 5, and may be precut from a sheet ofmaterial substantially similar to the material of which the main braceis formed, and when so cut it will have the general shape of the blankshown in Fig. 5. In other words, there will be provided an oval shapedportion 30 joined to another oval shaped portion 31 by a relativelynarrow band 32, the portions 30. and 31 having their major axes atsubstantially right angles to each other in the blank, and the band 32so formed that when the blank is folded and applied as indicated in Fig.2, the ovals 30 and 31 will be substantially coincident.

The oval 30 has an extension constituting a heel strap 33 the extremeend of which is provided with three tabs such as 34, 35 and 36corresponding similarly to, the tabs 7, 8 and 9 of the heel strap 3 ofthe main brace. In like manner the oval 31 has an extension constitutinga heel strap 37 the extreme end of which is provided with three tabs 38,39 and 40 corresponding similarly to the tabs 4, 5 and 6 of the heelstrap 3 of the main brace. Also lacings 41 and 42 are attached to theheel straps 33 and 37 respectively, and a cross strap 43 is carried byone of the heel straps, the parts 41, 42 and 43 being similarly formed,similarly placed, and for similar purposes, as the corresponding parts20, 19 and 17 of the main brace.

When the reinforcement is applied to the foot the middle of the strap 32is placed on the bottom of the foot and the two ends of thereinforcement brought upwardly and over to cross on the top of the footas indicated at 44 in Fig. 2 where the crossing portions of the strapmay be secured as by the stitching shown. The ends of the reinforcementsare then passed downwardly and under the foot where the ovals 30 and 31will ultimately lie, the heel straps 33 and 37 extending divergentlyrearward in substantially the same positions relative to the foot as theheel straps of the main brace above described. Likewise, according tothe size and shape of the foot of the patient, one of the tabs at theend of each heel strap will be cut ofi leaving'two which will passaround the heel and be secured in place in a manner similar to thatdescribed for the main brace. v

When the reinforcing brace is used in its entirety as shown in Figs. 2,3 and 5, and in conjunction with the main brace, the strap 32 is appliednext to the foot on the underside thereof at substantially the midpoint; then the toe portion of the foot is slipped into the cone 1 ofthe main brace and the remainder of the main brace applied tightly tothe foot, utilizing sufficient pressure to hold the muscles of the footin the desired positions intended. Then the remainder of the reinforcingstrap is crossed above the forward part of the foot and over the upperportion of the cone 1, and th n brought down over the outside ofthe'cone and underneath the same to maize the ovals 30 and 31 lieimmediately beneath the main portion 25 of the cone; then the heelstraps of the reinforcing member are tightly drawn rearwardly, passedabout the rear of the heel, and secured in place by whatever fastening(such as the buclde 45) is provided.

The modifications shown in Figs. 6, '7 and 8 embody the principles ofthe main brace structure shown in Fig. 1 in that there is provided theforward cone 1 which is fitted to the foot so that it accuratelyconforms with the contour thereof and will prevent the entire footpushing forward through the cone to a point where the cone becomesineflicient and inadequate to hold the muscles of the transverse arch.Joined to the cone at its under central part is a pair of heel strapsthe extreme ends of which, however, are not split or bifurcated, eachheel strap being a unitary member. According to the construction shownin Fig. 6 these heel straps provide only a single securement across theback of the heel;

in Fig. '7 these heel straps are made longer so that they cross eachother back of the heel and thence pass forwardly to encircle the ankle,the

correct tension of the brace as a whole being obtained in both of thesemodifications by use of a suitable fastener such as the buckleillustrated.

In Fig. 8 the construction of the brace is substantially identical withthat shown in Fig. 6 except an adjustable securernent of the forwardcone is provided by the use of a buckle instead of the stitching. AlsoFig. 8 contemplates a brace which can be used in combination with anordinary shoe, which has been provided with slits indicated at 50 oneach side of the forward part, to receive therethrough the ends of theforward cone forming straps as will be readily understood whereby, afterthe shoe has been put on the foot, the forward cone straps may be drawntightly and secured to create the proper tension on the forward arch ofthe foot. In a similar manner slots such as 51 are provided on the sidesof the shoe at a point substantially in line with the forward edge ofthe leather heel thereof in order that the two heel straps may be passedtherethrough to lie exteriorly of the shoe. The heel straps can then beadjustedfor tension as found suitable through the securing means such asthe buckle shown.

The advantage of the modified construction shown in Fig. 8 liesparticularly in the fact that some people have an arch condition whichis not so aggravated that a brace would have to be used for aconsiderable length of time, although such a brace should be used atmore or less frequent intervals to give relief and support to themuscles of the foot through use. Such people therefore might desire togo about their daily business, which naturally would necessitate or makedesirable the wearing of their shoes. It would be an inconvenience forthem to have to remove their shoes in order to adjust the braces, whichadjustments including the release of pressure could very easily be donewith the arrangements shown in Fig. 8.

The construction illustrated in Figs. 9 and 10 is another modificationalso involving the same principles heretofore described, in that thereis provided the cone 1 at the forward part of the foot carrying the heelstraps and 61 which are fashioned similarly to the heel straps 2 and 3,although they may if desired be lacking in the ankle encirclingportions. In other words, the two end tabs of eachheel strap may bedrawn tightly, cut off to measure. and then secured as by the stitching62 to provide an unadjustable heel stirrup into which the heel of thefoot is squeezed, the entire brace having additional pressure suppliedthereto through the utilization of lacings 63 similar to thosehereinbefore described. The main point of difference between theconstruction of this modification and those above pointed out lies inthe integral incorporation of a reinforcing member with the main brace.This reinforcing member comprises a strap 64 the mid portion of which ispositioned to lie in contact with the central under portion or arch ofthe foot as indicated at 65, the ends of said strap being brought up andcrossing themselves over the top of the cone 1 as indicated at 66 andthen extending down around the sides and the under portion of said cone.This strap is preformed of a length to lit the cone as well as the footof the patient and therefore it is possible to have it of a length sothat the extreme ends of said strap can be brought together in abuttingrelation as clearly indicated at 67in Fig. 10. Preferably the ends ofthis strap are flared or otherwise enlarged in area to provide a padeffect on the bottom of the cone 1 which will not be disagreeable oruncomfortable during walking. Stitching indicated at 68 secures the endsof this strap to the bottom of the cone 1.

The particular advantages in providing the reinforcing member in any ofthe constructions shown lie in the fact that an additional stress a maybe placed upon the muscles of the foot by its use. In other words, asthe cone 1 is drawn back upon the foot by pressures exerted through theheel straps, the foot will tend to cause the cone to expand, and this inturn will cause a foreshortening of the strap distance between the pointshown in Fig. 10 and the crossing of the strap shown at 66 in Fig. 9, asa result of which an upward pull is exerted on the muscles and flesh inthe under central portion of the foot. This naturally results in atendency to raise the longitudinal or main arch of the foot therebyrelieving the muscles associated therewith of undue strains and holdingthem up in place particularly when the weight of the body is notsupported by the'foot.

In certain foot conditions, it may be found advisable to use anadditional reinforcement in connection with the main brace, but it mightnot be necessary to use the entire reinforcing member as shown in Figs.2 and 5. In the modification last described and illustrated in Figs. 9and 10 it was shown how the reinforcing member could be utilized incombination with the main brace but devoid of any heel straps. Insteadof having the ends of the reinforcing strap 64 terminating in abuttingedges, as shown at 67, the blank reinforcing member illustrated in Fig.5 could be utilized by cutting off the heel straps along the dot anddash lines 70 and 71 and letting the two ovals 30 and 31 overlap underand be stitched to the cone of the main brace.

Also for some curative or remedial effects it might be foundadvantageous to place an additional bracing efiect only on one side ofthe foot. In such a case, for example, the blank shown in Fig. 5 couldbe out along the dot and dash line 72 using only the oval 31 with itsattached heel strap 37. Again, the blank shown in Fig. 5 might be usedby cutting along the dot and dash line 70 and utilizing the parts 30,31, 32 and 37 in a manner similar to that above described for obtainingnot only an additional pressure on one side of the foot but theadditional pressure created through the central part of the strap 32passing beneath the center of the foot. Obviously by cutting along thedot and dash lines 73 or 71 portions of the entire reinforcing membercould be obtained for application of additional pressures tothe oppositeside of the foot and similar to those just described.

The particular feature desired stressed isthe fact that braces made inaccordance with the above disclosures will be highly eflicient incurative or remedial effects due especially to (1) the provision of thecone forming portion of the brace encircling the forward arch of thefoot, and (2) the divergent dispositon of the heel straps. That is tosay, the cone formed either as a cone in Fig. 1 or as formed by thecross strap 32 shown in Fig. 2, will create a binding of the flesh andmuscles associated with the transverse arch of the foot when the braceas a whole is applied tightly to the foot, thus giving nature a chanceto remedy the laxity of the muscles and the fallen or broken downcondition of the'muscles and the honey structure forming said transversearch.

The other particular feature just recited, namely, the particulardivergent disposition of the heel straps, is important because suchdivergence causes the strains inherent in the brace to be distributed asnearly accurately as is artificially possible to create the remedialeffects on the transverse arch. In other words, and as perhaps canpossibly be shown in Fig. 10, there is illustrated the bottom of theleft foot to which is being the heel straps applied a remedial brace andit is quite clearly shown that the heel straps 60 and 61 are divergent,but they are connected by the cross strap 17 so that the degree ofdivergence is limited. When the brace is applied to this foot pressuresare exerted rearwardly through the heel straps which in turn cause thecone 1 to be drawn into very tight contact with the flesh of the foot atthe forward or transverse arch. Not only this, but the pressure exertedthrough the heel strap 60 will be transmitted in substantial coaxialprolongation of said strap to a point in the cone 1 on the side thereofadjacent the big toe; and-similarly the pressure exerted through theother heel strap 61 will be transmitted in substantial coaxialprolongation of said strap to a point in the cone 1 on the side thereofadjacent the little toe; in heretofore known types of orthopedic braces,the entire rearward pressure has been exerted only in a line whichincludes the longitudinal central axis of the foot, and therefore therehas been a tendency of such heretofore braces creating a buckling in anyportion thereof which was applied transversely about the forward. arch.As contradistinguished from this, the present invention contemplates thetransmission of pressures through in a direction transversely crossingthe foot, thus bringing the pressures to bear as much as possibleinwardiy from the extreme sides of the foot, resulting-in a greaterdegree of compactness of the flesh and muscles adjacent the transversearch, which results in at raising of said arch.

Summarizing the foregoing, it therefore results that this inventioncontemplates not only an orthopedic brace but one which can be made froma single sheet of material to the end that it can be fitted to apatients foot,then cut and stitched, much in the same manner as agarment is treated by a tailer. Thus while the blanks shown in Figs. 4and 5 can be furnished to orthopedists, yet they will require but littlechange in order to fit all shapes and conditions of feet. The limitationof the divergence of the heel straps is accomplished not only by thepositioning and securement of the cross straps such as 17, but also byoneof the tabs of each of the heel straps. In other words, the divergingheel straps will have a tendency to pass from under the foot to assume apositionon the rear and lateral side of the foot as shown in Figs. 6, 7and 8, but this increased divergence is prevented by the cross strap andalso by such straps as 5 and 8 illustrated in Fig. l which will assumelow positions around the sides of the heel, and thus made to prevent theheel straps from climbing higher than would be desirable. It may bedesirable in some instances to provide a single continuous heel strapinstead of the pair of straps illustrated in which case the single strapwill be made integral at one end with the cone-forming portion of thebrace, the other free end secured as by stitching to said portion afterfitting the brace to the foot, whereby the combined cone and heel strapmay still be formed unitarily from sheet material. The material fromwhich these braces are fiashicned contains no rubber as has beenheretofore used, and therefore the forward arch encircling portion ofeach brace after being fitted to the foot will have a dimensionincapable of yielding. In other words, by this invention there isprovided an efficient check of the spread of the arch which occurs whenthe weight of the body or a material portion thereof is sustained by thefoot atthe end of the normal spread of the arch, thereby preventing thenormal spread extending into a state of collapse. These braces exert notension when the foot is free of sustained weight and permit free bloodcirculation. I

It isobvious that those skilled in the art may vary the details ofconstructions as well as arrangements of parts without departing fromthe spirit of the invention and therefore it is not desired to belimited to the foregoing except as may be required by the claims.

Whatis claimed is:-

1. An orthopedic brace the same comprising a cone fitting the forwardarch portion of the foot;

9, pair of rearwardly diverging straps joined to said cone; and tabsformed on the rear end of each strap to secure the brace in position,one of the tabs of each strap encircling the ankle and another of thetabs of each strap encircling the heel, the ankle engaging tabs securedto each other and the heel engaging tab of each strap secured to theother strap.

2. An orthopedic appliance the same comprising a main brace and areinforcement therefor; the main brace having a forward arch encirclingportion of unyielding dimension held in place by rearwardly divergingstraps disposed under the foot and terminating in securing tabsencircling the ankle and the heel; the reinforcement comprising a strapdisposed under the foot back of the forward arch, the ends of the strapbrought upwardly over the sides of the foot, crossed on top of the archencircling portion, brought downwardly over the sides of and crossedbeneath the arch encircling portion, and extended rearwardly under thefoot, terminating in securing means.

3. A blank for forming anorthopedic brace from sheet material, saidblank comprising a portion generally of J shape which when securedaround the forward arch section of the foot will form a forwardlytapering cone; a pair of divergent straps joined to one edge of the coneforming portion in close juxtaposition said straps adapted to pass underthe foot and back of the heel to force the cone into binding relationwith respect to the forward arch section of the foot; and a plurality oftabs formed in substantial prolongation of each strap, said tabsdivergently disposed and adapted to encircle the heel and the ankle tosecure the brace on the foot.

4. A blank for forming an orthopedic brace from sheet material, saidblank generally of M shape and comprising a strap portion constitutingthe V of the M, said strap portion terminating in enlarged ovals, the.ovals having their major axes disposed substantially at right angles toeach other whereby when the strap portion is wrapped around the forwardarch section of the foot the strap will form a cage with the ovals inregistry and forming, a pad under the ball section of the foot; a pairof heel straps joined respectively to the ovals and constituting theouter legs of the M, each heel strap disposed at an angle to the majoraxis of its adjoined oval, said heel straps adapted to pass under thefoot and back of the heel to force the cage into bindingv relation withrespect to the forward arch section of the foot; and a plurality of tabsformed in substantial prolongation of each heel strap, said tabsdivergently disposed and adapted to encircle the heel and the ankle tosecure the brace on the foot.

GILBERT V. ARTHUR.

